Provider Demographics
NPI:1386630671
Name:CRISAN, VIORICA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:VIORICA
Middle Name:MARIA
Last Name:CRISAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 SAINT MELLION DR
Mailing Address - Street 2:
Mailing Address - City:PRESTO
Mailing Address - State:PA
Mailing Address - Zip Code:15142-1009
Mailing Address - Country:US
Mailing Address - Phone:412-600-1712
Mailing Address - Fax:
Practice Address - Street 1:651 COLLIERS WAY
Practice Address - Street 2:SUITE 406
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5053
Practice Address - Country:US
Practice Address - Phone:304-723-5670
Practice Address - Fax:304-723-5672
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2007-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20464207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2283916Medicaid
WV2000245000Medicaid
OH2283916Medicaid
H48839Medicare UPIN